Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period

No study has directly measured tissue lactate clearance in patients with sepsis during the post-resuscitation period. In this study we aimed to assess in ICU patients with sepsis ( = 32) or septic shock ( = 79)-during the post-resuscitation phase-the relative kinetics of blood/tissue lactate clearances and to examine whether these are associated with outcome. We measured serially-over a 48-h period-blood and adipose tissue interstitial fluid lactate levels (with microdialysis) and we calculated lactate clearance. Statistics included mixed model analysis, Friedman's analysis of variance, Wilcoxon's test, Mann-Whitney's test, receiver operating characteristics curves and logistic regression. Forty patients died (28-day mortality rate = 28%). Tissue lactate clearance was higher compared to blood lactate clearance at 0⁻8, 0⁻12, 0⁻16, 0⁻20 and 0⁻24 h (all < 0.05). Tissue lactate clearance was higher in survivors compared to non-survivors at 0⁻12, 0⁻20 and 0⁻24 h (all = 0.02). APACHE II along with tissue lactate clearance